Provider Demographics
NPI:1588449938
Name:CLOSMAN, CORTNEY KAY (LPN-C)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:KAY
Last Name:CLOSMAN
Suffix:
Gender:F
Credentials:LPN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21432 W STATE FARM RD
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:NE
Mailing Address - Zip Code:69143-4364
Mailing Address - Country:US
Mailing Address - Phone:402-517-6116
Mailing Address - Fax:
Practice Address - Street 1:601 MCDONALD RD
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5999
Practice Address - Country:US
Practice Address - Phone:308-535-7140
Practice Address - Fax:308-535-5368
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25459164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse